Hey all,

Just got back from my Radiation Oncologist visit. Unfortunately the cosultation that was to take place with the oral surgeon / dentist never materialized. He was called into emergency surgery. The radiation Oncologist read the results of my latest PET scan. He told me that a "few things" lit up on the test where my mandible was cut. He told me that it shows that there is metabolic activity in the area. Which he said shows that there is good blood flow. That put me to ease to some degree with my concerns over ORN. I discussed with him the need for my dental work. I explained as best I could the procedures that I will have done. He told me that I do not have to worry about ORN when I have the bridge made that will replace my three or four bottom front teeth, which are already dead. He said that ORN is a concern if I have to have my wisdom tooth removed. From his observation, my teeth and the inside of my mouth look excellent. He is very pleased with my overall condition and my weight gain.

He did prescribe Trental / 400 mg (I think I spelled it right) to be taken 3 times daily along with vitamin E. He wants to see if it will help with the fibrosis that I have from the radiation. Has anyone else tried this for fibrosis? He also feels that it may help in healing the fistula that I had develope after my treatments.

I still have to consult with the oral surgeon about the proposed procedure to make the bridge. I'll let you guys and gals know what I find out at that point.

Merry Christmas to all,

John

John, what kind of drug is Trental? You've got me curious.

John if all you need is a bridge fabricated, the oral surgeon is the wrong kind of doctor....they do not do bidgework. You need to see a general dentist or a prosthodontist.

Hi Eric,
There is a posting in the news section of the OCF site about various imaging techniques and their relative advantages and disadvantages.
See
http://www.oralcancerfoundation.org/news/story.asp?newsId=1072
for details.

It seems that every ENT and radiation oncologist have their own strategy for follow up. I'm about 18 months past the end of my radiation treatment and my ENT orders a CT scan every 6 months at this stage. The first year I had a CT scan every 3 months. As the article I referred to notes, it depends what the docs are looking for - nodal spread, recurrence at the original tumor site or distant mets. Each imaging technology has advantages and disadvantages.

I would suggest getting advice from a comprehensive cancer center as to what the best follow up regime should be. It must vary from patient to patient and doctor to doctor.
Best wishes, Sheldon

Nelie,

I've not had a chance to look it up yet. I think I spelled it correctly, trying to read the doctors handwriting is a stretch. I'll pick the prescription up today. I'll let you know what the pharmacist says about it. It's supposed to help with all the fibrosis I have from the radiation.

Brian,

The oral surgeon is in practice with his son who's my dentist. Not sure if he's going to be working on me with his son or not. He didn't make the meeting yesterday because of an emergency that came up. I'm not sure yet what they're going to do about this wisdom tooth. I would venture to say that if it has to come out, that the oral surgeon would do it?

It does feel as though the tooth has receded? It is not causing nearly the discomfort that it was a few weeks ago.

John

John,

A Google search is very fast on this. It appears to promote bood flow in the extremities. I'm no doctor, but it sounds like it could be a problem in pending, or recent, surgery. What are they doing about this fistula? It really sounds like you need a specialist in non-healing wounds. I try so hard not to make statements like this, but a fistula is not generally cosidered the sign of a successful procedure. I had one develope and they went right back in to correct it, you need that addressed.

Glenn

John,

When I say that I am talking about the overall surgery, not the cancer aspect of it all. There are still surgery related issues present.

Glenn

Glenn,

Did your fistula show up after your radiation? I never had it until about a month after I finished treatment. Everything that I've heard is that it's best if it heals on it's own. I've heard that the operation to take care of it, often times leads to more problems.

John

Pete had a PET/CT scan this week and got the ALL CLEAR!
I know there are different schools of thought on the procedure but, boy it feels great to get a good result.
We are off to Disney for the week.... with lighter hearts.
Merry Christmas Y`all.

Marica

Good point, mine was pre rads. The thing about yours, if I recall correctly, is that it is almost like a leak. With me, they opened it up and allowed it to heal from the inside out and this was still going on during radiation. I know post radiation tissue is different, but a lot of people here have had their surgery after rads. I just think you should see someone that deals specifically with non-healing wound care. It just seems that it is something that should be looked at more closely.